Swine flu claimed 4 lives in Mumbai last fortnight

Swine flu has resurfaced in Mumbai with a vengeance, claiming four lives in the last couple of weeks. Brihanmumbai Municipal Corporation's (BMC) health department on Thursday said of the 23 cases confirmed from city's public and private hospitals in the month of January, four died.

Ten of these patients reside in Mumbai, including a four-year-old girl from Santacruz and a nine-year-old girl from Goregaon. The rest have come from Gujarat, Bhopal or other peripheral parts to seek treatment. According to hospital sources the minor girls from Santacruz and Goregaon are now doing fine.

While a 60-year-old female, who was admitted to BMC-run Kasturba Hospital for Infectious Diseases since January 31, died on Thursday early morning, another 34-year-old female who was transferred from a Vashi-based hospital to Jaslok Hospital in Peddar Road succumbed to H1N1 on Wednesday.

"The 34-year-old female was in a serious state when she was brought to Jaslok. She slipped into one complication after another rapidly. She is on ventilator support," said Dr Om Shrivastava, infectious diseases consultant, Jaslok Hospital. Another 50-year-old female, admitted in Jaslok, is doing well, he added.

Ten days ago, a 56-year-old Jalgaon-based male, who was admitted to Kasturba Hospital, had died. "That was probably the first death recorded in Mumbai. Subsequently on February 3, a 61-year-old female from Palghar, admitted to Holy Spirit Hospital in Andheri, died," said Dr Mangala Gomare, epidemiologist, BMC.

According to BMC officials, the maximum infections are reported from western suburbs, followed by a few cases in South Mumbai. Also, one case has been recorded in eastern suburbs of Mulund. Of ten patients residing in Mumbai, maximum patients hail from western suburbs – Santacruz West, Bandra West, Mahim West, Malwani area of Malad West, Lokhandwala area in Andheri West, Gokuldham area in Goregaon East and Borivali. Three patients hail from South Mumbai areas of Peddar Road, Malabar Hill and Bhulabhai Desai Road.

Of 13 patients seeking treatment in the city, some hail from Bhopal and Gujarat. A 40-year-old female from Gujarat was transferred to Fortis Hospital in Mumbai ten days ago. "She had cough and fever since the past two weeks. The doctors could not detect her illness and referred her to Mumbai. There are hardly any laboratory facilities to conduct H1N1 tests in India," said Dr Pradip Shah, senior physician at Fortis Hospital. Another female in her late thirties who was admitted to Fortis with swine flu was discharged five days back.

Doctors have expressed concern regarding the virus, which is now affecting even healthy individuals. Earlier, only the elderly, children, pregnant women, patients on steroids or diabetics were seen to be vulnerable. "Up to five persons that initially died in Telangana were all healthy individuals. Most of the infected are from Rajasthan or Ahmedabad are some are healthy people without any co-morbidities," said Dr Shrivastava.

"We have issued a health advisory to all municipal corporations. We are making tami flu tablets available and Health department is closely monitoring the situation." - Health minister Deepak Sawant

Though Mumbai has recorded fewer cases as compared to other states, Dr Shah said that it is only a matter of time before the virus penetrates fully in the city, considering the fact that the city has three major laboratories that test swine flu and has become a hub of treatment for patients from other districts in Maharashtra and rest of India. The cost for getting a throat swab tested for H1N1 virus is between Rs 6000 – 10,000 in privately-run Religare labs. In government-run Haffkine Institute and Kasturba Hospital, the swine flu tests are conducted for free.

A senior doctor said requesting anonymity that the virus is undergoing an antigenic shift. "One strain of virus is getting clubbed with two or three other strains and attacking the patient. In the latest spurt, the virus is claiming lives with little warning. While earlier the patients would worsen over a period of week or recover, currently persons are getting breathless within the first 36 – 48 hours and succumbing to the illness. The virus attacks lungs, kidneys or other parts of the body and causes multi-organ failure," said the doctor.

Though there is no scientific evidence to say that patients are developing resistance to the Oseltamivir drug used for treating swine flu, the doctor said that some patients require higher doses for longer duration. Also, more females are succumbing as they do not tolerate the treatment well.

"Throat swab centres in the state will send samples of suspected patients to the labs and reports will be available within 24 hours. We strongly advise patients to not self medicate themselves and seek doctor's help in case symptoms emerge." - Health minister Deepak Sawant